Children with disabilities can qualify for disability benefits only through the Supplemental Security Income (SSI) program. Social Security Disability Insurance (SSDI) is available only to disabled people who have worked a certain length of time in jobs that have paid Social Security taxes. A child, even if 17 or 18, cannot have worked long enough to be insured under SSDI. (However, if a child's parent is disabled and collects SSDI, the child may be able to receive dependents' benefits. And after turning 18, a disabled teen could continue to receive SSDI benefits as a "disabled adult child.")
When awarding Supplemental Security Income (SSI) benefits to children, the Social Security Administration (SSA) accounts for the fact that diseases and impairments can have very different effects on children and adults.
SSI is for individuals with low income who have become disabled; there is an income and resource limit for children to qualify for this benefit. (For information on the income and asset limits, see our section on financial eligibility for SSI.)
The income and resources of the child are considered, as well as the income and resources of the family members that the child lives with. For example, a disabled child who lives at home with his parents will be barred from collecting SSI if his parents make above a certain amount of money. Even a child (anyone under 18) who does not live at home may still have the income and resources of their family members considered if she goes home periodically and is under the care of those family members when at home. (For more information, see our article on family income deeming for child SSI.)
Once the income requirements are met, a child must meet the basic medical eligibility requirements of SSI to be considered for benefits. The child must meet these requirements.
Unlike adults, children do not need to prove that they are unable to return to work. For SSI for children, the SSA's initial review includes the severity of the child's impairments and whether the child is working a significant amount. The SSA then makes a decision whether or not the child's functional limitations are severe enough to move forward into a full disability determination. (For example, if you apply for disability due to your child's learning disability, but your child performs at grade level, the SSA may not think it is a severe limitation and could deny your child benefits early on in the decision making process.)
In the full disability determination, the SSA has to try two ways to find your child disabled: through comparing your child's condition to the childhood disability listings and through an assessment of the child's limitations.
The SSA has a Listing of Impairments (called the blue book) that outlines impairments that automatically deem someone disabled. Part A of the blue book was created for adults. Part B of the blue book has separate disability listings for children. Often the criteria are the same as in the adult listings, but sometimes the criteria are easier to meet than in the adult listings.
For more information, see our articles on children's physical disability listings or children's mental, developmental, and cognitive listings.
If a child's medical condition does not meet the requirements a disability listing (or isn't found equivalent in severity to a listing), the child may still be deemed disabled if it is found that the child has functional limitations that are "marked and severe." These limitations must severely affect the child's ability to function on a daily basis. An example of a marked and severe functional limitation is a ten-year-old boy who cannot dress or bath himself. Another example would be a school-age child who needs two crutches or a walker to walk. For more information, see our article on how children's conditions can functionally equal the listings.
In order to prove that a child meets or equals a disability listing—or has functional limitations that are marked and severe—a good deal of evidence is required. Depending on the impairment, medical evidence requirements can range from doctor's observations to lab tests.
For children, medical reports should compare the child's functional abilities to others of the same age that do not have impairments. Functions that should be compared include learning and using information, the ability to complete tasks, the ability to interact appropriately with others, the ability to walk and use their hands, and taking care of themselves (as appropriate for their age).
The SSA will also consider school records and reports in considering the child's level of impairment.
If more medical information is needed, the child may be asked to have a medical examination or tests done. The SSA will cover the costs of such examinations or tests. Called consultative exams, SSA physical exams are performed by medical doctors (MDs) and SSA mental examinations are done by psychologists or psychiatrists, depending on the impairments. (For more information, see our section on consultative medical exams.)
The amount of time that a child may have to wait to begin receiving SSI benefits will depend of the speed with which the SSA decides if the child is disabled. Generally, it takes three to five months.
However, if a child has one of the specially noted conditions, the child will be able to receive disability payments immediately and for up to six months while their case is being decided (called "presumptive disability"). Some of the specially noted conditions include total blindness, total deafness, Down syndrome, low birth weight, cerebral palsy, and muscular dystrophy. For more information, see our article on presumptive disability.
Once a child is found disabled and is receiving disability benefits, the child may be subject to periodic reviews. If a child's condition is expected to improve, these ongoing reviews can be at least every three years. Even for those not expected to improve, their case may still be reviewed, although less frequently.
The disability reviews will look at the child's current medical condition to see it is improving and will look for evidence that the child is receiving necessary medical care for their condition. As long as the child is deemed to continue to be disabled and is receiving necessary medical care, the child should continue to receive SSI benefits. For more information, see our article on continuing disability reviews.